§ 97-18.1. Termination or suspension of compensation benefits.
§97‑18.1. Termination or suspension of compensation benefits.
(a) Payments ofcompensation pursuant to an award of the Commission shall continue until theterms of the award have been fully satisfied.
(b) An employer mayterminate payment of compensation for total disability being paid pursuant toG.S. 97‑29 when the employee has returned to work for the same or adifferent employer, subject to the provisions of G.S. 97‑32.1, or whenthe employer contests a claim pursuant to G.S. 97‑18(d) within the time allowedthereunder. The employer shall promptly notify the Commission and the employee,on a form prescribed by the Commission, of the termination of compensation andthe availability of trial return to work and additional compensation due theemployee for any partial disability.
(c) An employer seekingto terminate or suspend compensation being paid pursuant to G.S. 97‑29for a reason other than those specified in subsection (b) of this section shallnotify the employee and the employee's attorney of record in writing of itsintent to do so on a form prescribed by the Commission. A copy of the noticeshall be filed with the Commission. This form shall contain the reasons for theproposed termination or suspension of compensation, be supported by available documentation,and inform the employee of the employee's right to contest the termination orsuspension by filing an objection in writing with the Commission within 14 daysof the date the employer's notice is filed with the Commission or within suchadditional reasonable time as the Commission may allow.
(d) If the employeefails to object to the employer's notice of proposed termination or suspensionwithin the time provided, the Commission may enter an appropriate orderterminating or suspending the compensation if it finds that there is asufficient basis under this Article for this action. If the employee files atimely objection to the employer's notice, the Commission shall conduct aninformal hearing by telephone with the parties or their counsel. If eitherparty objects to conducting the hearing by telephone, the Commission mayconduct the hearing in person in Raleigh or at another location selected by theCommission. The parties shall be afforded an opportunity to state theirposition and to submit documentary evidence at the informal hearing. Theemployer may waive the right to an informal hearing and proceed to the formalhearing. The informal hearing, whether by telephone or in person, shall beconducted only on the issue of termination or suspension of compensation andshall be conducted within 25 days of the receipt by the Commission of theemployer's notice to the employee unless this time is extended by theCommission for good cause. The Commission shall issue a decision on theemployer's application for termination of compensation within five days aftercompletion of the informal hearing. The decision shall (i) approve theapplication, (ii) disapprove the application, or (iii) state that theCommission is unable to reach a decision on the application in an informalhearing, in which event the Commission shall schedule a formal hearing pursuantto G.S. 97‑83 on the employer's application for termination ofcompensation. Compensation may be terminated or suspended by the employerfollowing an informal hearing only if its application is approved. If theCommission was unable to reach a decision in the informal hearing, theemployee's compensation shall continue pending a decision by the Commission inthe formal hearing. The Commission's decision in the informal hearing is notbinding in subsequent hearings.
The employer or the employeemay request a formal hearing pursuant to G.S. 97‑83 on the Commission'sdecision approving or denying the employer's application for termination ofcompensation. A formal hearing under G.S. 97‑83 ordered or requestedpursuant to this section shall be a hearing de novo on the employer'sapplication for termination or suspension of compensation and may be scheduledby the Commission on a preemptive basis.
(e) At an informalhearing on the issue of termination or suspension of compensation, and at anysubsequent hearing, the Commission may address related issues regarding theselection of medical providers or treatment under G.S. 97‑25, subject toexhaustion of the dispute resolution procedures of a managed care organizationpursuant to G.S. 97‑25.2. (1993 (Reg. Sess., 1994), c.679, ss. 3.6, 10.9.)